Diabetes in Old Age THIRD EDITION

Diabetes in Old Age THIRD EDITION Diabetes in Old Age Third Edition Edited by Alan J. Sinclair © 2009 John Wiley & Sons Ltd. ISBN: 978-0-470-06562-4 Other titles in the Wiley Diabetes in Practice Series Exercise and Sport in Diabetes Second Edition Edited by Dinesh Nagi 978 0470 022061 Complementary Therapies and the Management of Diabetes and Vascular Disease Edited by Patricia Dunning 978 0470 014585 Diabetes in Clinical Practice: Questions and Answers from Case Studies Edited by N. Katsilambros, E. Diakoumopoulou, I. Ioannidis, S. Liatis, K. Makrilakis, N. Tentolouris and P. Tsapogas 978 0470 035221 Obesity and Diabetes Second Edition Edited by Anthony Barnett and Sudhesh Kumar 9780 0470 848982 Prevention of Type 2 Diabetes Edited by Manfred Ganz 978 0470 857335 Diabetes – Chronic Complications Second Edition Edited by Kenneth Shaw and Michael Cummings 978 0470 865798 The Metabolic Syndrome Edited by Christopher Byrne and Sarah Wild 978 0470 025116 Psychology in Diabetes Care Second Edition Edited by Frank J. Snoek and T. Chas Skinner 978 0470 015049 The Foot in Diabetes Fourth Edition Edited by Andrew J. M. Boulton, Peter R. Cavanagh and Gerry Rayman 978 0470 015049 Gastrointestinal Function in Diabetes Mellitus Edited by Michael Horowitz and Melvin Samson 978 0471 899167 Diabetic Nephropathy Edited by Christopher Hasslacher 978 0471 589924 Nutritional Management of Diabetis Mellitus Edited by Gary Frost, Anne Dornhorst and David R. Hadden 978 0471 962045 Hypoglycaemia in Clinical Diabetes Second Edition Edited by Brian M. Frier and Miles Fisher 978 0470 018446 Diabetic Cardiology Edited by Miles Fisher and John McMurray 978 0470 862049 Diabetes in Old Age THIRD EDITION Editor Alan J. Sinclair Bedfordshire & Hertfordshire Postgraduate Medical School, University of Bedfordshire, UK A John Wiley & Sons, Ltd., Publication This edition first published 2009 © 2009 John Wiley & Sons Ltd. Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing. Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Other Editorial Offices 9600 Garsington Road, Oxford, OX4 2DQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. Wiley also publishes its books in a variety of electronic formats. 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The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by physicians for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. ISBN: 978-0-470-06562-4 A catalogue record for this book is available from the British Library. Typeset in 9.75/11.75 Times Roman by Laserwords Private Limited, Chennai, India Printed and bound in Great Britain by Antony Rowe Ltd, Chippenham, Wilts First Impression 2009 Contents Foreword xi 3.3 Why detect diabetes? 23 3.4 The symptoms of diabetes 24 Preface xv 3.5 Glycosuria 25 3.6 Fasting plasma glucose and the modified oral List of Contributors xvii glucose tolerance test 25 3.7 Random and postprandial plasma glucose 27 3.8 Blood glucose meters 28 SECTION I EPIDEMIOLOGY AND 3.9 Glycosylated haemoglobin 29 PATHOPHYSIOLOGY 3.10 Fructosamine 30 3.11 Diabetes prediction calculators 31 3.12 Known diabetes 31 1 Pathophysiology of Diabetes In The Elderly 3 3.13 Types of diabetes 32 Graydon S. Meneilly 3.14 Metabolic syndrome 33 1.1 Introduction 3 3.15 Future research 33 1.2 Diet and diabetes in the elderly 4 3.16 Conclusions 33 1.3 Other factors 5 References 34 1.4 Metabolic alterations 5 1.5 Molecular biology studies 8 1.6 Glucose counter-regulation 8 SECTION III VASCULAR COMPLICATIONS 1.7 Conclusions 9 Acknowledgments 9 4 Peripheral Arterial Disease in Old People with References 9 Diabetes 41 2 Diabetes-Related Risk Factors In Leocadio Rodrıguez´ Mañas, Cristina Alonso Older People 13 Bouzon and Marta Castro Rodrıguez´ Stephen Colagiuri and Daniel Davies 4.1 Introduction 41 2.1 Introduction 13 4.2 Epidemiology of peripheral arterial disease 42 2.2 Age 13 4.3 Pathophysiology 42 2.3 Impaired glucose tolerance (IGT) and impaired 4.4 Clinical presentation 45 fasting glucose (IFG) 14 4.5 Diagnostic methods 46 2.4 Body weight 14 4.6 Treatment 47 2.5 Ethnicity 14 References 48 2.6 Gestational diabetes mellitus (GDM) 14 2.7 Family history 14 5 Coronary Heart Disease 51 2.8 Hypertension 15 2.9 Cardiovascular and cerebrovascular disease 15 Ahmed H. Abdelhafiz 2.10 Physical inactivity 15 5.1 Introduction 51 2.11 Antipsychotic medication and Mental Illness 15 5.2 Effect of ageing and diabetes on the 2.12 Sleep disorders 16 cardiovascular system 51 2.13 Smoking 16 5.3 Epidemiology 53 2.14 Conclusions 16 5.4 Cardiovascular risks 53 References 16 5.5 Myocardial infarction 61 5.6 Heart failure 63 5.7 Anti-diabetic medications and CHD 64 SECTION II SCREENING AND 5.8 Conclusions 66 DIAGNOSIS References 66 3 Diabetes in the Elderly: Diagnosis, Testing 6 Stroke and Diabetes 75 and Screening 21 Janice E. O’Connell and Christopher S. Gray Simon Croxson 6.1 Introduction 75 3.1 Introduction 21 6.2 Diabetes, hyperglycaemia and stroke risk in older 3.2 Definition of diabetes in the elderly 21 people 76 vi CONTENTS 6.3 Diabetes, post-stroke hyperglycaemia and 10.9 Pressure palsies 141 prognosis after acute stroke 79 10.10 Pathogenesis of diabetic peripheral neuropathy 142 6.4 Diabetes, hyperglycaemia and acute stroke 10.11 Autonomic neuropathy 142 treatment 80 10.12 Management of painful diabetic neuropathy 144 6.5 Stroke prevention in type 2 diabetes 84 References 146 6.6 Conclusions 87 References 88 11 Erectile Dysfunction 149 Tamás Várkonyi and Peter Kempler 7 Diabetes-Related Renal Disease in Older 11.1 Introduction 149 People 93 11.2 Erectile dysfunction: An observable marker of Latana A. Munang and John M. Starr diabetes mellitus? 150 7.1 Introduction 93 11.3 Risk factors of erectile dysfunction 150 7.2 Changes in the diabetic kidney 93 11.4 Pathophysiology of ED in diabetes mellitus 151 7.3 Screening for diabetic renal disease 94 11.5 Erectile dysfunction: A first sign of 7.4 Chronic kidney disease 95 cardiovascular disease? 151 7.5 Management of diabetic renal disease 95 11.6 The artery size hypothesis: A macrovascular 7.6 Managing cardiovascular risk 97 link between ED and CAD 152 7.7 Management of CKD and its complications 97 11.7 Other causes of erectile dysfunction 152 7.8 Conservative management of renal disease 98 11.8 Differentiation between organic and 7.9 Conclusions 99 psychogenic erectile dysfunction 153 References 100 11.9 Treatment of erectile dysfunction in diabetic patients 153 11.10 Conclusions 158 8 Management of Eye Disease and Visual Loss 103 References 158 Nina Tumosa 8.1 Introduction 103 8.2 Risk factors 103 SECTION IV TREATMENT AND CARE ISSUES 8.3 Management of diabetic retinopathy 104 8.4 Treatments of diabetic retinopathy 106 12 Metabolic Risk Factors, Obesity and 8.5 Conclusions 109 Cardiometabolic Syndrome 165 References 110 Raffaele Marfella and Giuseppe Paolisso 9 The Diabetic Foot 113 12.1 The definition of metabolic syndrome 165 12.2 Pathogenesis of the metabolic syndrome 167 Andrew J.

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